OPTIMIZING ANTIMICROBIAL DRUG-USE IN SURGERY - AN INTERVENTION STUDY IN A DUTCH UNIVERSITY HOSPITAL

Following a one-month prospective study of antimicrobial drug use in s urgical departments, new guidelines were implemented. The review was r epeated after two years. In both study periods, one third of patients were prescribed antimicrobial drugs. Prophylactic antibiotic consumpti on decreased from 0.75 to 0.53 defined daily doses/operation. Complian ce with guidelines improved from 32% to 79%. Duration of prophylaxis > 24 h decreased from 21% to 8%. Single dose prophylaxis increased from 34% to 80%. Quality of the prophylactic courses improved, as evaluate d by experts using established criteria. For prophylaxis, cost savings amounted to 57%. Better quality of therapeutic courses was associated with a cost increase of 15%. Indicators of satisfactory outcome with the new policy were a stable median length of stay (5.5 days in the fi rst review and 5.0 days after intervention) and a reduction in the num ber of nosocomial infections treated with antimicrobial drugs/100 bed days (1.0 before intervention vs 0.77 after intervention).